2024 年第 11 期 第 19 卷

羟氯喹在肾脏疾病治疗中的应用进展

Advances in the application of hydroxychloroquine in the treatment of kidney diseases

作者：王瑶白彝华杨欢肖丽莹邱杰何振坤

英文作者：Wang Yao Bai Yihua Yang Huan Xiao Liying Qiu Jie He Zhenkun

单位：昆明医科大学第二附属医院肾脏内科，昆明650000

英文单位：Department of Nephrology the Second Affiliated Hospital of Kunming Medical University Kunming 650000 China

关键词：肾脏疾病；IgA肾病；狼疮肾炎；羟氯喹

英文关键词：

• 摘要：

• 羟氯喹作为一种抗疟药，其毒性小，且具有抗炎、调节免疫、免疫抑制、预防血栓等作用，不仅用于治疗疟疾，还用于治疗风湿免疫性疾病。随着研究的深入发现羟氯喹可通过抑制炎症信号的级联反应、抑制自噬及免疫反应复合物形成等方式，减轻肾脏损伤，减少或延缓蛋白尿的发生；因而被用于治疗IgA肾病、狼疮肾炎等与炎症反应密切相关的肾脏疾病，并且发现羟氯喹在肾脏疾病方面的运用与其他免疫抑制剂相比安全性更高，此外羟氯喹在糖尿病肾病、膜性肾病等其他肾脏疾病中的治疗效果也备受关注，其作用机制及潜在安全性问题也值得进一步研究。

• Hydroxychloroquine, as an antimalarial drug, has low toxicity, anti-inflammatory, immunomodulatory, immunosuppressive and thromboprophylaxis effects. It is not only used in the treatment of malaria, but also in the treatment of rheumatic immune diseases.As the research progressed, it is discovered that hydroxychloroquine can mitigate kidney damage by inhibiting the cascade of inflammatory signaling, suppressing autophagy, and preventing the formation of immune response complexes, thereby reducing or delaying the occurrence of proteinuria. Hence, it is utilized for the management of kidney diseases associated with inflammatory responses, such as IgA nephropathy and lupus nephritis. Moreover, hydroxychloroquine has demonstrated a superior safety profile in comparison to other immunosuppressants for treating kidney diseases. Furthermore, the therapeutic efficacy of hydroxychloroquine in additional kidney conditions like diabetic nephropathy and membranous nephropathy is highly esteemed, warranting further investigation into its mechanism of action and potential safety considerations.